The current application is in response to PAR-12-010 entitled NIH Competitive Revision Applications for Research Relevant to the Family Smoking Prevention and Tobacco Control Act (R01). The current application will significantly expand the aims of a currently funded parent grant via RFA-CA-08-024 (Measures and Determinants of Smokeless Tobacco (ST) Use, Prevention, and Cessation) entitled Predictors of smokeless tobacco and dual use in the military (R01CA141567). The grant is tracking 30,000 Air Force Airmen to determine the onset of ST use, smoking and dual (ST and cigarettes) use through 2 years of follow-up. The US Military is an extremely high-risk population for tobacco use given the youth, stress of combat deployment, and targeted marketing by the tobacco industry of the soldiers. Our cohort has a cigarette smoking prevalence rate of 31%, a ST use rate of 14%, and the prevalence of dual tobacco use exceeding that of ST use. Over the past 18 years, we've recruited over 80,000 military personnel into our tobacco-related studies. Our current proposal has two major aims. First, we propose to address the issue of new and emerging tobacco use trends in the US military. Specifically, we will: Determine baseline and follow-up prevalence and predictors of new and emerging tobacco products including (a) ST products such as snus and dissolvables (i.e., orbs, sticks, and strips); (b) electronic nicotine delivery devices (ENDDs; ie., www.blucigs.com); (c) waterpipe (Hookah); and (d) roll your own (RYO) cigarettes; (2) Determine baseline and follow-up prevalence and predictors of the perceived health benefits and perceived harm reduction of these new and emerging tobacco products relative to cigarette smoking among US Airmen; (3) Evaluate the natural history of harm reduction behavior (e.g., quit cigarette smoking by using a new and emerging product) as well has harm escalation (e.g., nonsmoker to smoker).; and (4) Assess the communication channels that military personnel use to receive information and communicate about tobacco and related health issues. Our second major aim would be to cost-effectively collect the above data on a new cohort of 5000 active duty personnel. We will supplement this cohort by using the new questionnaire in the parent grant for the 9-month period when we are accruing new baseline participants. We will follow this total cohort of approximately 12,000 Airmen for one year. In summary, by extending this NIH-funded project by partnering with the FDA, we will have continued comprehensive data on the changing prevalence and predictors of new and emerging tobacco products currently being marketed. PUBLIC HEALTH RELEVANCE: Tobacco companies are introducing new and emerging tobacco delivery products at an alarming rate. We need to have insight to who is at risk for adopting these products, and why, so targeted public health interventions can be developed.